Worked to the bone

A doctor discovers a Western and Chinese treatment blend that saves SARS survivors with problem hips after receiving therapy. Sun Ye reports in Beijing.

Editor's Note: Ten years ago, the world was hit by the Severe Acute Respiratory Syndrome (SARS) epidemic. Thousands lost their lives, including medical workers all over the world who selflessly looked after patients in spite of the high risks of infection. In China, the effects of the dreaded virus still reverberates to this day. In a series of reports, China Daily highlights the human faces behind the news.

Most people think about the respiratory system when they think about SARS. Chen Weiheng knows it can also affect the pelvis.

The 50-year-old doctor and director of the China Academy of the Chinese Medical Sciences' Wangjing Hospital has spent the past decade treating patients with pelvic bone necrosis caused by the hormone therapies used to treat SARS and the necrosis often causes the affected pelvis to collapse.

The doctor has used a myriad of treatments and much research to slow the cellular death of his patients' hips. He has employed surgery, intravenous infusions of traditional Chinese medicine, arterial injections, Western drips, DNA analyses - anything he can to maintain skeletal integrity.

He has saved hundreds of patients from losing their joints to metal replacements.

His mission began with the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak.

The orthopedic specialist was enlisted to the SARS medical corps when hospitals ran out of respiratory physicians in the spring. Chen was anxious, but he answered the call.

"Like every other doctor, I believed it was my responsibility," he recalls.

Chen had focused on avascular necrosis of the femoral head (ANFH) since 1991. ANFH occurs when bone tissue dies and the bone often collapses due to a lack of blood flow to the top of the femur. This has happened to many SARS survivors who received hormonal treatments.

Chen hadn't ventured much outside of Western medicine until SARS. The Western solution to ANFH is, generally, to replace the joint with a metal prosthetic that lasts 20 years at most.

Chen was also one of the few experts who knew high hormone doses and alcohol could kill bone tissue.

He used TCM to improve circulation to counter the hormonal treatments' deleterious effects on bone tissue while on the SARS team. He also published an article warning of the possibility of post-SARS bone necrosis.

An examination of Beijing medical staffers' bone health in August 2003 found 130 healthcare providers who were infected with SARS - about one in three - had ANFH.

Chen was appointed head of the post-SARS ANFH team in 2004.

"I was under unprecedented pressure," he recalls. "Suddenly, there were so many patients pushing me to find a cure."

Chen increasingly found Western remedies weren't working. He considered replacement therapies to be "treatment failures", he says.

"I trained in TCM but preferred Western medicine because it was like shooting with a very focused rifle," Chen says.

"In this case, it seemed like TCM's broader machine-gun-like spray might work better."

Chen and his team began experimenting. They tested pathological mechanisms and herbal medicines, sifting through the data to determine a key ingredient in the fight against ANFH, and then retesting their results for validity.

TCM allowed Chen to discover a link between blood lipid levels and bone growth. He was able to strengthen bones at risk by using traditional medicine to boost blood lipids.

But TCM's drawback, in this case, was time, or the lack of.

"The traditional method for brewing and absorption by topical application was too slow to achieve the effect we needed," he says. "We needed speed."

So, his team began experimenting with such techniques as using IVs to administer TCM.

This approach has been honed over the years so that 70 percent of patients treated this way don't need hip replacements.

"They can stabilize their necrosis and sacrifice neither their lives nor their legs," Chen says.

Chen's latest endeavor is to examine the genetic differences that make some people more susceptible to ANFH.

"If we succeed, we can do screenings to preempt ANFH's onset," he says.

But his research must be done after hours. His daily shifts in wards, operating rooms and consultation offices end at 5 pm or later.

But he persists because he's both a doctor and an adventurer by nature, he says.

And he can't turn away those SARS patients with whom he's worked on for the past decade.

He remembers growing up watching his father - a self-taught surgeon - perform operations next to his family's living room in Guangdong province's Nan'ao.

"Other kids might have been afraid, but I was fascinated by what Dad did," he recalls.

His unorthodox personality perhaps also pushed him to go beyond convention to blend Chinese and Western medicine.

"We'll use whatever works," he says.

Chen says he has become emotionally attached to the SARS patients he has worked with.

"Suddenly, so many people depend on you, and you stay with them for a long time - a decade, even," he explains.

Chen sets aside time every Thursday afternoon for these patients.

Chen Bo, one of them, endures the long bus ride across the city every week to see the doctor.

"I could go to other designated hospitals, but I chose to follow Dr Chen because I know he cares," Chen Bo explains.

"He's familiar with my condition and fine-tunes my treatments. We've known each other for a long time and talk about more than medicine. He cares about my work, family and feelings."

Chen Weiheng explains: "The more you know about the patients, the more you can do for them."

Chen's wife, a China Academy of the Chinese Medical Sciences researcher, has joined her husband in the fight against ANFH.

She examines effective TCM drugs to isolate active ingredients.

"Our family discussions are about drug mechanisms," Chen says.

"Actually, it's embarrassing: I have no life other than fighting ANFH."

He spends his free time reading and writing about the condition, and answering questions about it on the online medical forum, Haoyisheng.com.

"I can't stand watching other people sitting around reading the newspaper," Chen says.

"When you work with life and death, you can't afford to waste time."

The doctor tries to pass his work ethics on to his students.

One of his graduate students, Li Yan, says: "Teacher Chen summons us to crunch stats on national holidays."

Chen says working on the frontline of SARS during its peak was one of the most hectic periods of his life.

"Doctors deal with emergencies often, so I can't say those few weeks changed me," he says.

"But I've devoted all my energy since to ANFH research because of its aftermath. In this way, SARS has determined my path long after the outbreak."

Contact the writer at sunye@chinadaily.com.cn.

(China Daily 02/27/2013 page20)